CT abdomen and pelvis with contrast at Banner Payson Medical Center. CPT 74177.
What Banner Payson Medical Center publishes for this service, straight from its standard-charges file, last updated September 22, 2026.
Outpatient / ER
$1,061cash price (self-pay)
$2,097list price
$242–$1,887range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Arizona Physicians IPA | Medicaid | $242 |
| Banner University Health Plan | AZ Medicaid - AHCCCS | $242 |
| Health Choice Arizona, Inc. | Medicaid | $242 |
| Health Net | Medicaid | $242 |
| Mercy Care | Mercy Medicaid | $242 |
| Aetna | Banner Employee Plans | $358 |
| Banner Health | Medicare Advantage | $860 |
| Aetna | Medicare Advantage | $860 |
| Arizona Physicians IPA | Medicare Advantage | $860 |
| Banner University Health Plan | Medicare Advantage | $860 |
| Blue Cross Blue Shield of Arizona | Medicare Advantage | $860 |
| Cigna Healthcare of Arizona, Inc. | HMO Medicare Advantage Plan/PPO Me | $860 |
| Gila River Health Care Corporation | Managed Care Program | $860 |
| Health Choice Arizona, Inc. | Medicare Advantage | $860 |
| Health Net | Medicare | $860 |
| Kaiser Foundation Health Plan | Medicare Advantage | $860 |
| Mercy Care | Mercy Care Advantage | $860 |
| Carekin | Medicare Advantage | $903 |
| Humana | Medicare Advantage | $911 |
| National Healthcare Solutions Inc (NHSI) and VIP Universal Medical Ins | $944 |
| Plotkin Health | Plotkin Health | $944 |
| Arizona Priority Care | Medicare Advantage | $946 |
| Devoted Health Services | Medicare Advantage | $946 |
| Gold Kidney Health Plan | Medicare Advantage | $946 |
| Aetna | Joint Venture | $1,093 |
| Health Choice Arizona, Inc. | ACA Health Plan | $1,290 |
| Health Net | Commerical Exchange Product | $1,298 |
| Blue Cross Blue Shield of Arizona | BXBSAZ Neighborhood | $1,304 |
| Aetna | Medical Rental | $1,325 |
| Aetna | Broad Network | $1,365 |
Inpatient
$1,061cash price (self-pay)
$2,097list price
$944–$1,887range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| National Healthcare Solutions Inc (NHSI) and VIP Universal Medical Ins | $944 |
| Plotkin Health | Plotkin Health | $944 |
| Aetna | Medical Rental | $1,325 |
| Quiktrip Corporation | Commercial | $1,457 |
| Cigna Healthcare of Arizona, Inc. | Commerical/HMO Benefit Plan/Local | $1,627 |
| Arizona Medical Network | Commercial | $1,812 |
| Provider Network of America | Commercial | $1,887 |
Billed more than this?
Scan my billSnap a photo of your bill. We compare every line with these prices and coding rules, free.